Yes, but those outcomes did not correlate with policies or government actions to any noticeable degree. I won’t say they didn’t correlate at all - clearly Taiwan’s quarantine-on-entry was highly effective, for example - but most countries indulged in a lot of completely random stuff with no scientific basis. The effects were very hard to observe, not least because nobody really knew what the effects should have been. They were literally just throwing stuff at the wall to see what sticks.
Good question. You’d think researchers would be all over that one, wouldn’t you? The silence has been deafening.
As I’ve said before, my guess is that (a) quarantine was very effective but also (b) it’s been simmering here all along. They’re only seeing cases and deaths because they’re looking harder - a COVID death, in the absence of a test, looks pretty much like any other respiratory disease ending in pneumonia, and old people in particular often die of such things. That would certainly explain the massive (initial) explosion in positive test rates: no country in the world has gone from 0-60 like that. It would also explain why the TPR is relatively flat.
So they decided not to rapid test quarantine hotel staff , CAL staff regularly, nor did they do random screening of vulnerable populations such as sex workers, homeless …
Big fail. Look where we are now. Don’t let perfect be the enemy of good. Rapid tests will pick up majority of transmission some have excellent false negative rates , over 99% specificity.
You’re talking about specificity but what you think you’re talking about is sensitivity.
Compared with real-time reverse transcription–polymerase chain reaction (RT-PCR) testing, the Sofia antigen test had a sensitivity of 80.0% and specificity of 98.9% among symptomatic persons; accuracy was lower (sensitivity 41.2% and specificity 98.4%) when used for screening of asymptomatic persons.
To account for reduced antigen test accuracy, confirmatory testing with a nucleic acid amplification test (e.g., RT-PCR) should be considered after negative antigen test results in symptomatic persons and positive antigen test results in asymptomatic persons.
We don’t know whether this outbreak was caused directly by the pilots, or by the quarantine breaches at Novotel.
Bottom line, reducing quarantine for unvaxxed pilots to 3 days was stupid. Hell 5 days was stupid because this is still slightly lower than the median incubation time for the virus. Letting pilots quarantine at home was stupid. Not exercising stringent oversight of quarantine hotels was stupid. Letting a quarantine hotel also service non-quarantine guests and promoting it for domestic tourism was stupid.
Rapid antigen testing has its place, but it’s not a substitute for adequate quarantine protocols and it should not be considered dispositive in asymptomatic populations.
You are correct even though I know this field quite well it’s easy to confuse things sometimes.
The specificity of a test, also referred to as the true negative rate (TNR) , is the proportion of samples that test negative using the test in question that are genuinely negative
But however we put it…Good antigen tests give very high true negative rates ! It means they are very good at screening out folks who DONT have disease.
When I reviewed the antigen tests available some have more than 99% specificity.
If they had been used regularly together with better quarantine they would have made a big difference. The clusters would have been detected earlier (the novotel staff and the pilot cluster in CAL ).
The key with antigen tests is you can do then often and more easily than PCR.
Well, that is why you have the test positivity rate figures and they are not too bad. So of course not all cases are identified, but it is not off the mark by several orders of magnitude compared with many other countries
Yep, you only need to test a fraction of the population to get an idea of the spread especially if there’s a trend line established.
So, cautiously optimistic here that the situation has stabilised at minimum. Of course there is always weeks of lag in terms of hospitalization and deaths.
Looking for an interesting read on a rainy weekend?
If so, consider having a look at this interview with a geographer at NTU who has studied what has happened with various forms of lockdown around the world. His takeaway? Bottom up approaches (as opposed to harsh top down measures) are the way to go to manage and minimize spread in Taiwan. In this piece published by Commonwealth Magazine, he explains why.
As I noted in my post, this guy is not an epidemiologist.
He’s a geographer who is evidently also interested in how human psychology / behavior is critical to managing spread in Taiwan until vaccines can finally arrive.
Since the geographer interviewed in the piece above emphasizes bottom up approaches (i.e. those affecting us on the ground), there is still something valuable here to take away for the forumosan community in Taiwan: are resources available in our local communities? Do we still have access to a variety of food? Basic things like that. If people on the ground are OK in these ways, the geographer suggests, the situation can be managed until vaccines arrive.
I didn’t see that message in the article, and in any case it’s a bit obvious that you need to get your food supplies sorted if the government is about to severely restrict your access to food. People on the ground are guaranteed to not be OK if you impose “level 4 lockdowns” and enforce them with the police and the military.
He was talking about the practicalities, costs, tradeoffs, and usefulness of lockdowns, and the opposite of “top down” (meaning rule-by-diktat) in this context, is not “bottom up” but “democratic”. In other words giving people the information they need, setting out some guidelines where necessary, and then letting everyone decide what they’re going to do with that.
Yes. Some of us have been saying this from the beginning and it’s nice to have support.
Bioenvironmental Systems Engineers who specialize in geographies of disease spread would be even more relevant for our current situation and, certainly, less common.
Area-based epidemic prevention through the use of zones is a good idea. I believe - actually, I know - that it was discussed early last year though I’ve been unable to find what was published. Early in the pandemic, we had maps of zones that the Taipei area was supposed to use if the virus spread here and authorities were fairly confident that it would hold. Considering that we have vaccines already developed and initial spread was confined to Wanhua then, later Banqiao, I am not sure why we’ve gone away from it.
I cannot think of a single area in northern Taiwan that couldn’t sustain itself as long as logistics to transport goods remain operational. Walk out your front door - could you do grocery shopping, banking, receive health care and do pretty much everything you needed within a few km?
I disagree that what he’s proposing is really a ‘bottom-up’ (i.e. grassroots) approach and believe that it sounds more like handling things at a neighborhood level rather than having the gov’t lock people in homes.
